Summary of findings 5. Erectile function ‐ short term.

Minimally invasive treatments versus transurethral resection of the prostate
Patient or population: men with moderate to severe lower urinary symptoms due to benign prostatic hyperplasia Interventions: minimally invasive treatments. Comparator (reference): sham procedure or transurethral resection of the prostate Setting: hospital procedure – outpatient follow‐up
Outcome: erectile function Measured by: IIEF scores range 5‐25 (higher scores indicate better function). Follow‐up 3 to 12 months
6 studies 640 participants	Anticipated absolute effect (95% CI) *		Certainty of the evidence	Ranking (SUCRA) **
	With TURP	With a minimally invasive procedure
CRFWVT (Rezūm) (indirect estimate)	Mean score in the included studies: 15.16 (range 11.67 to 17.70)a	6.49 higher (8.13 lower to 21.12 higher)	⊕⊝⊝⊝ VERY LOW b c d	2.5 (70.7%)
TIND (indirect estimate)		5.19 higher (9.36 lower to 19.74 higher)	⊕⊝⊝⊝ VERY LOW b c d	2.9 (61.7%)
PUL (UroLift) (mixed estimate)		3.00 higher (5.45 lower to 11.44 higher)	⊕⊝⊝⊝ VERY LOW b c d	3.5 (49.5%)
PAE (mixed estimate)		0.03 lower (6.38 lower to 6.32 higher)	⊕⊝⊝⊝ VERY LOW b c d	4.4 (31.1%)
TUMT	Not reported
CI: confidence interval; CRFWVT: convective radiofrequency water vapor therapy; IIEF: International Index of Erectile Function; IPSS: International Prostate Symptom Score; MD: mean difference; PAE: prostatic arterial embolization; PUL: prostatic urethral lift; SUCRA: surface under the cumulative ranking curve; TIND: temporary implantable nitinol device; TUMT: transurethral microwave thermotherapy; TURP: transurethral resection of prostate. Network meta‐analysis summary of findings table definitions: * Estimates are reported as mean difference and confidence interval (CI). ** Rank statistics is defined as the probability that a treatment out of n treatments in a network meta‐analysis is the best, the second, the third, and so on until the least effective treatment. Between brackets are the surface under the curve (SUCRA) estimates.
GRADE Working Group grades of evidence (or certainty of the evidence). High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

^aTURP was the lowest‐ranked intervention for this outcome with a mean rank of 4.6 (SUCRA 27.2%)

^bDowngraded by one level due to major concerns on within‐study bias: nearly all studies contributing to this estimate had an overall high risk of bias.

^cDowngraded by one level due to major concerns on imprecision: the estimate crosses the threshold for minimally important difference (five points for IIEF‐5) including substantial benefits and harms.

^dDowngraded by one level due to major concerns on incoherence: the network does not present close loops to assess incoherence.